Overview

Population Characteristics

  • This dataset include 53 confirmed cases admitted from 2025-08-29 to 2025-09-25.

  • 53% women and 9% children ≤5 years.

  • 33 confirmed deaths reported for an average CFR of 62%.

Sampling

Cases Description

Patient Outcomes by Admission Delay

  • Deceased patients (n=33) had a median admission delay of 5 days (IQR range 3-7)
  • Recovered patients (n=53) had a median admission delay of 4 days (IQR range 2-7)

Ct kinetics

Note

Interpretation note: Currently limited to 37 participants with available Ct value.

Note

Interpretation note: Currently limited to 37 participants with available Ct value.

Cases and CFR

Treatments and complications

Analyses

Approach

flow ImmuneMod Immune modulation DelDirect Deleterious direct effect of virus ImmuneMod->DelDirect +/- ViralLoad Viral load ViralLoad->DelDirect + OrganFail Organ failure DelDirect->OrganFail + Death Death OrganFail->Death + PreExist Pre-existing comorbidity PreExist->OrganFail + Age Age Age->PreExist +/- Sex Sex Sex->PreExist DelayedPres Delayed presentation Sex->DelayedPres Nutrition Nutrition Nutrition->PreExist + DelayedPres->ViralLoad + Vaccination Vaccination Vaccination->ViralLoad - Antiviral Antiviral therapy Antiviral->ViralLoad - Hypoperf Hypoperfusion / shock Hypoperf->OrganFail + Dehydration Dehydration Dehydration->Hypoperf + MetElect Metabolic / electrolyte derangement Dehydration->MetElect + MetElect->OrganFail + Hypoxa Hypoxaemia Hypoxa->OrganFail + Anemia Anaemia Anemia->Hypoxa + SecInf Secondary infection SecInf->OrganFail + SecInf->Hypoxa + Bleeding Bleeding Bleeding->Anemia + ORS ORS ORS->Dehydration - IVfluid IV fluid IVfluid->Dehydration - IVfluid->MetElect - Diarrhoea Diarrhoea Diarrhoea->Dehydration +
workflow A 1. Data cleaning and wrangling B 2. Univariate model screening • Identify sparse variables • Exclude predictors causing quasi-complete separation A->B C 3. Collinearity assessment • Variance Inflation Factor (VIF) • GVIF_scaled ≤ 1.68 B->C D 4. LASSO regression • Shrinks weak predictors • Retains strongest associations C->D E 5. Multivariable logistic regression • Include LASSO-selected predictors D->E F OR from multivariable model E->F G Adjusted RR (Poisson) E->G H Raw RR for binary predictors E->H

Ct threshold to predict participant outcome

  • ROC analyses were performed to determine the optimal Ct threshold to predict participant outcome.
  • With an area under the curve (AUC) of 0.95, ROC analyses evaluated the optimal Ct threshold cut-off at 19 for predicting patients outcome (sensitivity 79%, specificity 77%).

Independent Predictors of EVD Outcome and Complications

Symptom Grouping Used for Analysis
Category Variables
CNS signs confusion_agitation, cephalee, conscience_alteree
Bleeding signs hemorragie, hematemese, signes_cliniques_d_anemie
Gastrointestinal signs nausees, douleur_abdominale, diarrhee, vomissements, anorexie, signes de malnutrition
Renal signs insuffisance renale aigue
Respiratory signs episode d'hypoxemie,difficulte respiratoires/essoufflement,toux

Note

Method: Multivariable Poisson regression with robust standard errors was used to estimate adjusted risk ratios (aRR) and 95% confidence intervals.

Variable Reported Relative Risk (95% CI) Direction
Duration of Infection (days) 0.96 (0.92-1.01) ↔︎
Choc 16/37 2.04 (1.07-3.89) ⬆
Respiratory Signs 24/37 2.24 (1.09-4.62) ⬆
Bleeding Signs 12/37 1.13 (0.45-2.8) ↔︎
Antibiotherapy 14/37 0.79 (0.37-1.67) ↔︎
MAb114 15/37 0.86 (0.37-1.96) ↔︎

Note

Method: Multivariable Poisson regression with robust standard errors was used to estimate adjusted risk ratios (aRR) and 95% confidence intervals.

Logistic Regression of Factors Associated with Death and Complications

Final LASSO-Selected Logistic Regression: EVD Outcome
Multivariable model including LASSO-selected predictors
Characteristic N Present Event N OR 95% CI p-value Significance1 Direction Unadjusted RR2 Adjusted Risk Ratio (95% CI)3
Duration of Infection (days) 37
19 0.89 0.78, 0.98 0.033 * ⬇
0.96 (0.92-1.01)
Choc Signs 37 16 19 9.25 1.32, 109 0.040 * ⬆ 2.25 2.04 (1.07-3.89)
Respiratory Signs 37 24 19 6.39 0.79, 80.6 0.10 ⬆ 2.89 2.24 (1.09-4.62)
Bleeding Signs 37 12 19 2.66 0.32, 29.5 0.38 ⬆ 2.31 1.13 (0.45-2.8)
Antibiotherapy 37 14 19 0.48 0.00, 47.1 0.78 ⬇ 0.44 0.79 (0.37-1.67)
MAb114 37 15 19 0.87 0.01, 116 0.96 ⬇ 0.52 0.86 (0.37-1.96)
Abbreviations: CI = Confidence Interval, OR = Odds Ratio, NA
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.
2 Raw risk ratios (RR) were calculated as the ratio of the risk of death among participants with the condition (Yes) versus without the condition (No).
3 Adjusted risk ratios (RR) obtained from Poisson regression with robust standard errors. RR > 1 indicates increased risk; RR < 1 indicates decreased risk.

⚠️ Caution: The effect of Duration of infection may be misleading — shorter duration can imply severe cases with rapid death.

Survival Analyses

Note

Method: We used a Weibull proportional hazards model to estimate survival probabilities over time.

Important

Note: Forest plot showing relative effects of covariates on survival time estimated from a Weibull proportional hazards model. HR > 1 indicates shorter survival (faster occurrence of the event), HR < 1 indicates longer survival. Error bars represent 95% confidence intervals.

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